Seeking advice as to why he is coming off and re attaching

I am so concerned that our BFing relationship is beginning to end I have called the Lactation Consultant I saw the other week and left a message but in the meantime does anyone have any suggestions. This is the problem:

Within 30 seconds of starting to feed (regardless of which side) he pulls off, then re attaches. He will sometimes cry out and get upset and frantic as he tries to latch back on. When he eventually does latch on he is only on for a few seconds before pulling off again and repeating the saga. He will pull on the nipple also. It is almost as if he is not getting any milk and is frustrated, however I can hear him gulping and I can also see milk in his mouth and pouring out of the corners of his mouth. I don't think supply is the issue as when I squeeze my breasts milk squirts out in all directions. I have tried all the tips and advice for oversupply. Can anyone offer any help???

I wasn't able to BF my first son and because this is my last child I am really keen for it to work out. This baby is 5 weeks old today.

Others will give better advice than I can give, but it sounds to me like a fast let down? Try feeding lying down, or taking him off as soon as you get a let down, squirt some milk into a towel, then reattach him.

Agree that it sounds like a fast let down. I had exactly the same problem - finally got baby latching at about 3 weeks, then at 5-6 weeks she was frantic/screaming from the let down.

The kellymom link the PP has given goes through all the typical tips.

I would say that the problem seems to arise at around this time, you aren't alone.

For me I just persisted with what worked for us such as feeding when sleepy. I had a difficult latch so feeding laying back was hard for me, but I did get the hang of feeding lying down on my side which slowed things down. Eventually DD just grew bigger, my supply settled and it was all fine. It did take a few weeks though. We're still feeding at 2 years, so it definitely wasn't the end!

Definitely see the LC as soon as you can. You can also call the ABA in the meantime, it is a common issue so they should be able to work with you to work out a few strategies that might work for you.

I think having the LC watch a feed will be ideal, she will be able to see what exactly he is experiencing and why he is doing what he does.I'm wondering whether he doesn't have a deep latch of the breast when this is happening, ie if he had your nipple deep he would be more likely to stay on the breast when you started to let-down as it sounds like your milk release is strong and the deeper in the mouth your nipple is, the better he will cope with flow, even if it is strong. Nipple deep in mouth means milk goes directly to the back of the mouth and baby can coordinate suck/swallow/breathe better.Milk coming out the sides of his mouth may be evidence of this, ie if nipple is deep the milk is swallowed (gulped/sculled) rather than leaking.If milk is not going to the back of the mouth it can be overwhelming to baby and he will come off in distress, often spluttering.As to why your nipple may not be deep enough, I don't know, the LC will be able to assess this, ie do you need to soften your areolar before attaching baby is it is full of milk and tight=less depth of latch?Or is he used to a shallow latch to try and cope with a fast flow but unfortunately it is a counter-productive move, it makes feeding harder for baby?Does he have some difference in his mouth that restricting your nipple going deeply?In the meantime you could-- check that your areolar is soft and easy to grab prior to each feed, hand expression to soften if needed- try to get an uneven latch, ie try to position his bottom lip as far away from you nipple as possible (nipple just folds under top gum) this will put more areolar over his tongue and hopefully get your nipple past his hard palate- consider a more upright position for feeding, ie bum lower than head, he may cope better- ensure his chest and chin are tucked in close to your breast and his nose is off you breast (forehead tilted back), he may cope better- worst case scenario is expressing milk and giving by an alternative means if he is unable to drink enough to grow and/or you have overfull breasts and are at risk of blocked ducts +/- mastitis.

What I have suggested may not be relevant to you so please ignore me if I'm off track, that's why seeing you LC would be the most helpful thing to do.You could also ring the ABA Helpline until you speak to or see your LC.All the best.

eta, ha, I needn't have posted, we have all suggested very similar things, good luck!

I would say you're doing an awesome job and he's coming up to 5-6 weeks when your breasts get more efficient. Him pulling on the nipple is to get a let down so perhaps express to your first let down and then put him on? If he's coughing and spluttering it would indicate a fast let down so it doesn't sound like that.

It will change next week . Keep an eye on wet and dirty nappies, growth and look at the baby (happy, cheerful, bright eyed) and take one day at a time. You are doing a great job.

I agree with Kacee, I had the exact same problem when DS was younger. Very fast letdown, meaning the poor little thing was choking. The link kacee posted is excellent, a lifesaver for me!

What worked for me was block feeding (explained in the link)- feeding DS only from one breast per feed, for two or three feeds in a row. Feeding lying down is one of the best things I did, just put a towel underneath your baby's head to catch the inevitable leaks. I often fed DS sitting on the couch with my feet up, knees bent, so that he was partially sitting up. By about 4 months old DS was feeding from both sides per feed.

It is very frustrating, but I don't think it means the end of your breastfeeding relationship - there are things you can do to adapt how you feed and give your little one time to get used to the fast flow. DS is almost 8 months old and still feeding

I had exactly the same problem!!! Everyone I spoke to told me it was fast letdown!!! I went to the pediatrician and he diagnosed silent reflux. No vomitting, just means that the acid was coming up and burning my daughter in her throat. The pediatirician suggested mylanta (I think it was only 1ml) before breastfeeding, and problem solved. Maybe you can investigate this too???

Mine is doing the same thing and I think it's the let down, because when he pulls off there's a strong squirt of milk, Block feeding has helped a lot- I just give two or three feeds on each side before changing- I've been to,d it also assists in providing more of the fattier 'hind milk' so he's a bit more settled.l. The MCHN said that the baby eventually learns to regulate the flow, so just keep letting him attach, pull off, then reattach. Express a bit if you have to, but pretty much just relax and allow the feed to take as long as it takes.

My dd did that starting at 2 1/2 weeks. She would whimper, come off, cry and then attack the nipple again hungrily. She was diagnosed with silent reflux too. She would feel pain when the acid/milk would come up, come off and then wanted to be fed constantly for a week until diagnosed and put on mylanta. I also have a really fast letdown (as in suck, suck whoosh) but it doesn't bother her at all. Does your ds whimper while still attached or arch his back/wriggle around whilst feeding? These are the things my dd does when having an acid attack

It doesn't have to mean the end of breastfeeding. Mine is still doing it at 14 months. Initially he did it because of a forceful let down. Now he does it because the let down is too slow to come and so he switches from one side to the other and back agian until I get a let down.

I agree that the advice on Kellymom is very useful in this regard. It helps you feel like you've got some options to tackle it rather than "What the hell do you want from me?!" frustration.

We're another silent reflux case here - DS started doing the behaviour you described at about 3 weeks old, MCHN and LC said it was a forceful letdown (which I do have), but he just kept getting worse and started becoming miserable all day as well. I put it down to him being a colicky baby, but by 12 weeks he was getting worse, not better. It was awful. Feeding him was incredibly stressful and with every feed dissolving into tears for both of us I tried to wean him, but no one could get him to take a bottle. He slept well at night, so I hadn't really given reflux any thought until one of my friend's midwife/MCHN mum suggested silent reflux. He had heaps of the symptoms with the fussing at the breast, pulling off and arching away, screaming, congested nose etc. The GP agreed to trial a course of Losec and it took a good 2 weeks but he is like a different baby. He is now happy and content and doesn't pull off from his feeds screaming anymore.

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